Making the case for Wegovy coverage: Drug keeps weight off for 4 years, aids heart health

Drugmaker Novo Nordisk has released two new trial results that could strengthen the case for insurers and government agencies to cover the cost of Wegovy, its popular but expensive weight-loss treatment. Patients taking the drug maintained an average 10% weight loss after four years, and results from a previous trial showed that Wegovy reduced the risk of serious heart problems, such as strokes and heart attacks, by 20%

“This is the longest study we’ve conducted so far of semaglutide for weight loss,” said Martin Holst Lange, Novo’s head of development, referring to the active ingredient in Wegovy and the company’s diabetes drug Ozempic. “We see that once the majority of the weight loss is accrued; you don’t go back and start to increase in weight if you stay on the drug.”

According to the report “clinically meaningful weight loss” was achieved among all sexes, races, body sizes and participants in different geographic regions. Wegovy mimics the hormone GLP-1, which causes insulin secretion and regulates appetite. Approved uses for GLP-1 agonists so far include treating diabetes, obesity and most recently, reducing the risk of major cardiovascular events. People taking Wegovy enjoyed those benefits regardless of their weight when they first started taking the drug or how much weight they lost while on it.

“Our findings show that the magnitude of this treatment effect with semaglutide is independent of the amount of weight lost, suggesting that the drug has other actions which lower cardiovascular risk beyond reducing unhealthy body fat,” said Professor John Deanfield from University College London, who led the study.

Results from the same multinational trial sponsored by Novo Nordisk were cited by the U.S. Food and Drug Administration earlier this year when it approved Wegovy for reducing the risk of major cardiovascular events.

Previous studies have found that stopping the use of GLP-1 agonists results in patients regaining some or all of the weight they had lost while taking the medication. A 2022 study found that participants regained about two-thirds of the weight they lost about one year after they ended treatment. Researchers in the new trial acknowledged some limitations, including the lack of numbers on racial subgroups that could reveal “potential differential effects.” The trial also did not account for body composition information, such as fat mass and muscle mass.

Much of the discussion about Wegovy and similar weight-loss drugs has been less about efficacy than cost. The list price in the United Sates for Wegovy is $1,349 for a month’s supply.

Related: Aetna, other insurers will start covering weight loss drug Wegovy for heart

“The implications of weight loss of this degree in such a diverse population suggests that it may be possible to impact the public health burden of the multiple morbidities associated with obesity,” the report said.